Core Fit Canine Conditioning and Massage   

If you are interested in enrolling in any of the canine massage or fitness programs, please complete this form. It helps me learn more about you and your dog so I can better understand your goals and your dog’s individual needs.

Once I receive your form, I will review the information and then contact you to answer any questions. We can also schedule your appointment at that time if one has not already been arranged.

For pricing information, please visit the “Services” section of Core Fit Canine or feel free to contact me directly at: petrav7369@gmail.com

Thank you — I look forward to working with you and your dog! 🐾  -- Petra Vasilik
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Note (Fitness only): If your dog is in pain, lame, or recovering from an injury, Core Fit Canine is not allowed to perform fitness without a veterinary clearance.

If you participate in Fitness and/or Massage:  Please print and sign this waiver and bring to your appointment (or email to me at petrav7369@gmail.com) 

Thank  you!  

Dog's name

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Breed/Age/Sex: 


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Weight:
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Injuries/Surgery/Illness, including chronic and known structural conditions:


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Exercise/Sports/Activities:


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Diet/Supplements: 


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Food allergies:


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Medications:


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Describe treat/food motivation:
*

Disposition (i.e. happy, shy, reactive, spatially sensitive…):


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Are any areas of your dog’s body sensitive to touch?


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Is your dog comfortable with sitting or laying on an elevated platform?
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Has your dog ever shown signs of aggression or bitten a human?  Yes/No. If yes, please explain.

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(Fitness only) Describe toy motivation:
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(Fitness only) What kind of balance and stability equipment do you own?


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(Fitness only) Does your dog know targeting skills? (nose touch, rear/front foot targeting, chin rest):


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(Fitness only) What kind of cues/commands does your dog know?


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Client Information

Client’s Name:



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Client's Email, Phone#: *

Veterinarian Name and Phone:


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Referred by:
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Client’s Goals and Objectives:
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(Fitness) Do you have any physical limitations? (back/knee problems, etc.)


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Thank you! I will contact you shortly! If you need to cancel your appointment, please give us at least a 24 hour notice.  Forms of payment: Cash, Check, Venmo or Paypal.
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